What Happens to Healthcare Professionals When There’s No Time to Pause?

Physicians and healthcare professionals are often seen as the ones who take care of everyone else. They work long hours, make high-stakes decisions, and carry a great deal of responsibility. But behind this professional role, many physicians are quietly carrying stress, exhaustion, and emotional strain. Heavy workloads, fear of making mistakes, having less free time to rest (even the idea of rest might cause guilt), and exposure to traumatic events every day can impact overall well-being. Regardless of how much their role impacts them, physicians and healthcare professionals often hesitate to ask for help. This is because the medical world has unspoken expectations of being strong, resilient, and perfect. So admitting emotional challenges might seem like a failure. In such circumstances, where you are not allowed to express your needs, it is highly likely to struggle with anxiety, depression, or suicidal thoughts. Also, it is possible to turn to unhealthy coping mechanisms like substance useto deal with mental health struggles. The good news is that support is possible. Depending on the symptoms, physicians may benefit from therapy, medication, a combination of both, and daily supportive practices. In this mini sketch, we will explore common occupational challenges that may affect physicians’ mental health, the most common mental health struggles they report, and ways to improve their psychological well-being.

Physicians experience occupational challenges that could affect their mental health

Physicians and healthcare professionals do not leave their work when their shift ends most of the time. They generally work under serious time pressure and consequences; their decisions can have serious consequences, and they are expected to stay focused, emotionally steady, and available even when they are tired or emotionally exhausted. The nature of the profession generally does not provide any moment to pause or slow down. However, these challenges do not capture the full picture. There are many additional, often overlooked factors that also shape physicians’ mental health and daily experiences:

Training demands: Becoming a physician involves rigorous, highly competitive training, including admission to medical school, completing residency and specialization, and maintaining clinical and scientific competence as their careers progress.
Hierarchical relationships and disempowering practices: The medical profession often faces criticism for its distressing practice culture. Interactions between experienced and trainee professionals tend to suffer from disempowering practices, sometimes even escalating to bullying, teasing, mobbing, discrimination, and harassment. For example, “pimping” (Wigg et al., 2024), a teaching method where experienced professionals ask difficult or intentionally unanswerable questions to trainees, remains in use despite criticism of both its approach and its name. It is reportedly used to challenge trainees to reinforce authority and hierarchy.
Frequent witnessing of traumatic or distressing details: Physicians and healthcare professionals frequently witness traumatic and significantly distressing details of other people’s lives as a part of their jobs, especially when providing care for people who experience accidents, violent events, or assaults. Sometimes, physicians are unfortunately also victims of traumatic events themselves, such as patient violence toward physicians.
Stigma: It is reportedly common among physicians and medical trainees to not seek help for their mental health struggles due to associated stigma and concern for confidentiality and negative career repercussions. For instance, 40% of physicians surveyed for a study said that they would be reluctant to seek mental health care because they are concerned about its effect on their medical licensure (Dyrbye et al., 2017).

Physicians frequently experience mental health challenges, including depression and anxiety

The factors that we mentioned above generally invade personal life as well, and they can lead to the following mental health challenges (Couser et al., 2024):

Burnout: Burnout happens when chronic stress cannot be managed effectively. It can manifest as emotional, physical, or mental exhaustion, as well as a feeling of being less motivated and unable to perform well, making it difficult to function at work and in other areas of life. For physicians, long hours, high caseloads, and dealing with life-and-death situations can contribute to burnout.
Depression: The combination of occupational challenges, personal experiences, and the personal sacrifice required in the medical field might be making physicians vulnerable to developing depressive symptoms. Physicans for instance, may develop feelings of hopelessness, helplessness, and extreme sadness, loss of pleasure, feelings of worthlessness, and other negative experiences.
Anxiety: Stress regarding patient treatments, potential malpractice issues, or the need to stay updated with the constantly changing medical knowledge can make anxiety a constant struggle for physicians, and at times, this may become more pressing or chronic.
Post-Traumatic Stress Disorder: Physicians are often exposed to traumatic situations, such as natural disasters, violent assaults, or patient deaths. As a result, these experiences can lead to symptoms of Post-Traumatic Stress Disorder (PTSD), including flashbacks, avoidance behaviors, and arousal or reactive symptoms.
Substance Abuse: Sometimes physicians may turn to substances as a way to cope with their stress. Extensive knowledge of substances and potentially easier access to drugs may be risk factors for self-medication.
Compassion Fatigue: Constantly caring for patients who are in pain or distress can be emotionally exhausting. Compassion fatigue, also known as secondary traumatic stress, happens when doctors and healthcare professionals start feeling overwhelmed by the ongoing demand to offer emotional support to their patients.
Imposter Syndrome: Aiming for the perfect performance all the time and constant comparison are also common among physicians and trainees (Peters & King, 2012). These experiences can lead to imposter syndrome, in which they feel they are not competent or capable in their field, even when there is evidence to the contrary.

This is how therapy can help?

Therapy can be incredibly helpful to alleviate and manage symptoms of various mental health struggles, improve well-being, and help cultivate resilience and positive experiences for physicians. Some therapeutic goals are not limited to, but may look like the following:

Help address and differentiate between private and occupational stressors, and understand how they uniquely interact to cause distress for that individual.
Address and help manage challenging symptoms and negative emotional experiences, such as burnout.
Help set personal and occupational goals to improve well-being, achieve one’s personal and professional aspirations, while cultivating protective and positive experiences.
Identify and help utilize personal and social resources for support.
Foster a sense of autonomy and confidence.

Daily practices that physicians can incorporate into their lives to support themselves:

In addition to seeking individual therapy, certain practices have been found to be effective in improving physicians’ psychological well-being (Hirayama et al., 2024):

Identify stressors through reflective practices: Taking the time to reflect on stressors, through practices such as journaling and meditation, can help physicians prioritize areas of their lives that could use improvement.
Exercise: Regular physical activities, such as walking, jogging, or yoga, can help release tension and boost overall well-being.
Seek peer support: Peer support is an effective mental health intervention for healthcare professionals. Peer support programs offer occupational mentoring and psychological support to help physicians navigate occupational challenges, build community with peers, and model helpful coping behaviors. For instance, university, campus, and hospital-based support programs have become increasingly more available.
Practice mindfulness: Mindfulness involves deliberately paying attention to your experience, including your senses, while cultivating acceptance or offering a nonjudgmental perspective. This could be done through meditation, breathing exercises, or even when making a cup of tea or coffee, by deliberately bringing your awareness and acceptance to the experience for as little as 5 minutes. Mindfulness is known to improve mood and attention, and more structured mindfulness-based interventions have been shown to contribute to physicians’ psychological well-being and performance.

Takeaways:

Physicians and healthcare professionals face both private and occupational challenges that can affect their mental health and well-being.
Occupational challenges can be extensive training and working conditions, disempowering practice culture, emphasized stigma toward seeking help, and witnessing traumatic details as a part of one’s job, which could potentially lead to mental health struggles.
Physicians experience mental health challenges, including symptoms of depression, anxiety, as well as experiences of burnout and compassion fatigue.
Physicians and healthcare professionals can benefit from therapy, medication, a combination of both, and daily supportive practices, including mindfulness, to improve their mental well-being.

References

Couser, G. P., Newcomb, R. D., Swift, M. D., Hagen, P. T., & Cowl, C. T. (2024). Physician Health Series, Part 3: Physician Mental Health. Mayo Clinic Proceedings, 99(7), 1178–1186. https://doi.org/10.1016/j.mayocp.2024.01.020

Dyrbye, L. N., West, C. P., Sinsky, C. A., Goeders, L. E., Satele, D. V., & Shanafelt, T. D. (2017). Medical licensure questions and physician reluctance to seek care for mental health conditions. Mayo Clinic Proceedings, 92(10), 1486–1493. https://doi.org/10.1016/j.mayocp.2017.06.020

Hirayama, Y., Khan, S., Gill, C., Thoburn, M., Hancox, J., & Muzaffar, J. (2024). Enhancing well-being in medical practice: Exploring interventions and effectiveness for improving the work lives of resident (junior) doctors: A systematic review and narrative synthesis. Future Healthcare Journal, 11(4), 100195. https://doi.org/10.1016/j.fhj.2024.100195

Peters, M., & King, J. (2012). Perfectionism in doctors. BMJ, 344, e1674. https://doi.org/10.1136/bmj.e1674

Wigg, L., Li, W. W., & Leow, T. (2024). A Systematic Review and Meta-analysis on Teaching by Humiliation in Medical Training: Its frequency and impact on the mental health outcomes of medical trainees. Medical Science Educator, 35(1), 569–585. https://doi.org/10.1007/s40670-024-02213-7

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